|
|
|
| GUEST COMMENTARY June 7, 2005 |
|
|
Building toward full health care access By Senator Richard T. Moore Our Nation’s leaders, at least since the Truman Administration more than fifty years ago, have advocated reform of our health insurance system. Improving access to health care is an ongoing process that involves government at all levels, the private sector, and the people of Massachusetts as a whole. At the beginning of the current legislative session, Senate President Robert Travaglini challenged us all to reduce the approximately 532,000 uninsured in Massachusetts by at least fifty percent in the next two years. Governor Romney and Speaker DiMasi have also expressed support for such a goal. Comprehensive reform of health care requires a much more extensive effort than simply expanding access to health care. To achieve the goal of a truly caring Commonwealth, we must improve quality and safety in health care, increase access and utilization of technology, promote greater consumer involvement at all stages, restructure the medical malpractice system to reach all who may be injured by systemic errors, and develop sustainable financing less subject to the vagaries of state revenues. No one bill is likely to achieve all of these objectives. Furthermore, achieving the goal of a caring Commonwealth will require a reallocation of resources and a review of the level of investment in the health of our citizens. It cannot be achieved without the partnership of the Federal government, and we are concerned that changes in federal programs and policies may well make our job more difficult, perhaps even impossible. In addition, health care consumers – every citizen – must be our partners by becoming informed consumers of health care, especially if government provides them with tools needed to access to their own health information; and they need to adopt healthy lifestyles that promote good health. A recent hearing by the Committee on Health Care Financing marks an important step in the process of health care reform. The Committee has begun the complex process of analyzing several bills that seek to reduce the ranks of the uninsured and underinsured and to strengthen our health care delivery system. The Roman philosopher and statesman, Seneca, once observed that “Having good health is very different from only being not sick.” Two thousand years later this statement is just as true. We know that, in order to have good health, one must have regular access to health care; and that can best be accomplished through private or public health insurance or a combination of the two. The uninsured may not all be sick, but their lack of access to regular care reduces their chances for good health since they are unable to have access to prevention and screening to help the keep from becoming seriously ill. Those of our fellow citizens who must rely on the emergency department for their health care only get help when they are sick. The Institute of Medicine of the National Academies of Science, in its report entitled “Insuring America’s Health,” noted that: “Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States. Although America leads the world in spending on health care, it is the only wealthy, industrialized nation that does not ensure that all citizens have coverage.” Massachusetts, while more successful than most other states in promoting insurance coverage, still has about 532,000 of its citizens without health insurance. The IOM report offered five principles for analyzing proposals to reform health care in the United States. The principles for guiding the debate and evaluating various strategies are: 1. Health care coverage should be universal. I am the principal sponsor of similar pieces of legislation currently being considered by the Committee on Health Care Financing which, to one degree or another, attempt to implement those five principles. Senate Bill No. 738: the Health Access And Affordability Act appears strongest in its objectives to offer full health care coverage that is universal and continuous, and is affordable to individuals and families. The bills provide for significant reforms of the insurance market and fund the expanded coverage through a so-called pay or play employer mandate and an increase in the cigarette tax. The bill also expands Mass Health eligibility and benefits to strengthen the “health care safety net.” The linked pair of bills numbered Senate Bill Nos. 2042 and 2043 Providing For Health Access, Affordability And Accountability, are designed to build toward full coverage through strategies that appear to be affordable and sustainable for society without increasing taxes and by embracing a “free rider” charge to encourage all but the smallest businesses to help with the costs of their employees who must rely on the Uncompensated Care Fund for health access. These bills also seek to promote access to high quality care through investments in provider payments, quality measurement, infection control and prevention. Senate Bills 738, 2042 and 2043 have many good points in their favor and, I am confident, that comprehensive health insurance reform is possible to achieve in this legislative session. Improving access to care will not only help to make health insurance more affordable for individuals and small businesses, insurance reform and improvements in provider payments will reduce cost shifting and reliance on the Uncompensated Care Pool, both of which drive up the cost of premiums for those who are already insured. Health insurance reform will be a major step toward making Massachusetts a caring Commonwealth! |
|
